What Research Is There?

Short answer: There is very little. Almost everything we know about neurodivergence comes from white people in high-income countries, yet most neurodivergent people live in low- and middle-income countries and are not white. Social media is a much better place to look for lived experiences of non-white neurodivergent people than academic research, but it still misses out huge swathes of neurodivergent lives and experiences.

Who Am I To Write This?

I am a multi-neurodivergent, queer, white-passing, anglophone sex and relationship therapist in private practise and a researcher. I am multicultural both in terms of the diverse ethnicities of my parents and their socio-cultural backgrounds. I acknowledge that some of these identities accrue privileges that I haven't earned and are often invisible to those who hold them, while simultaneously creating barriers for those who don't. These identities form and inform who I am and how I practise as a therapist.

As a teenager in the 90s, I avidly devoured the writings of Homi Bhabha and bell hooks, assuming that greater representation was just around the corner. A few decades later, we can assess how ineffective many of these equality and diversity policies really were—particularly for neurodivergent people in the Global South.

What Do We Know? (The Statistics)

Although there is limited statistical data available on neurodivergent populations across different racial and ethnic groups, we have some estimates on global prevalence. Looking specifically at ADHD:

• Global Prevalence (2020): Persistent adult ADHD (diagnosed in childhood) sits at 2.6%, while symptomatic adult ADHD (late diagnosis) is 6.8%. This translates to roughly 140 million and 366 million adults, respectively (Song et al.; 2021).
• Income Disparities: Adult ADHD prevalence is higher in high-income countries (approx. 3%) compared to low-income and lower-middle-income countries (approx. 1.4%) (Popit et al.; 2024).
• Regional Variations:
  • Arab Countries: Prevalence ranges significantly from 0.5% to 19.6% (Alhraiwil et al.; 2015).
  • East Asia: Mainland China (6.5%), Hong Kong (6.4%), and Taiwan (4.2%) (Liu et al.; 2018).
  • African Nations: Pooled prevalence in children and adolescents is reported at 7.5%, with regional reports in South Africa and Ethiopia varying between 5.4% and 8.7% (Ayano et al.; 2020).

What Is The Problem?

Most quantitative and qualitative studies largely describe participants in terms of age, sex, and sexuality, with rarely any mention of culture, first language, or ethnicity. This creates a massive data void.

Most neurodivergent research is conducted on children and young people. While 90% of the world’s children live in low- and middle-income countries, only 10% of research is performed there (Franz et al.; 2017). Furthermore, language acts as a gatekeeper; in one review of ADHD in women, 1,782 papers were excluded simply because they were not written in English (Kelly et al.; 2024).

Shining a Cultural Light

Put simply, almost everything we know about neurodivergence comes from white, rich, anglophone people researching other white, rich, anglophone people. Until very recently, the field has been funded and conducted almost exclusively by white men in high-income countries.

This article aims to reveal the epistemic injustice of this unearned privilege. It highlights the urgent need to recalibrate our understanding of what it is to be neurodivergent, with an active emphasis on neuro-affirmative, anti-racist, and anti-oppressive approaches.

If this topic resonates with you, you might also be interested in our reflections on why representation by lived experience matters in research, such as in Trans Research by Trans & Non-binary Researchers, or how neurodivergent content creators are reshaping conversations around sex and relationships.